What it is
Major Depressive Disorder (MDD) is more than a bad week. It’s a health condition marked by persistent low mood and/or loss of interest plus changes in sleep, appetite, energy, focus, or feelings of worth. It’s common and highly treatable.
Common signs and symptoms
If several show up most days for 2+ weeks and affect daily life, consider reaching out:
- Mood and interest: sadness, emptiness, irritability, or numbness; less pleasure in activities
- Energy and sleep: fatigue, sleeping too much or too little; trouble falling or staying asleep
- Appetite/body: eating more/less; weight changes; slowed movements or feeling agitated
- Thinking: trouble concentrating or making decisions; negative or self-critical thoughts
- Emotions: guilt, hopelessness; feeling like a burden
- Safety: thoughts of death or self-harm (seek urgent help)
Depression can look different across ages and cultures; sometimes it shows up as headaches, stomach pain, or chronic pain.
Why it happens
Usually a mix of:
- Biology: family history, brain chemistry, hormones, medical conditions, certain medications
- Stressors: grief, trauma, financial/housing stress, burnout, discrimination
- Environment: isolation, poor sleep, low daylight/activity
- Protective factors: support, routine, movement, purpose, stable housing
You didn’t cause this—and you can get better.
What helps right now
- Tiny actions: one small daily task (shower, step outside, make tea, text a friend)
- Movement: 10–20 minutes of gentle activity most days
- Sleep anchors: regular wake time, morning light, simple wind-down routine
- Food and hydration: small, regular meals; water nearby
- Thought skills: notice all-or-nothing thinking; ask, “What’s a more balanced view?”
- Reduce alcohol/drug use: these can worsen mood and sleep
Evidence-based treatments
- Psychotherapies
- CBT: skills to change unhelpful thoughts/behaviors
- Behavioral Activation: structured activities to restart motivation and pleasure
- Interpersonal Therapy (IPT): grief, role changes, conflict, support
- Mindfulness-based therapies: reduce rumination and relapse
- Medications
- First-line: SSRIs/SNRIs; others based on symptoms (e.g., bupropion for low energy, mirtazapine for insomnia/low appetite)
- Expect 2–6 weeks for benefits; side effects often manageable—discuss with a clinician
- Combined care
- For moderate–severe MDD, therapy plus medication often works best
- Options for hard-to-treat depression
- rTMS, esketamine/ketamine clinics, ECT (especially for severe/urgent cases)
- Treat co-occurring insomnia, pain, or substance use concurrently
When to seek help now
- Symptoms most days for 2+ weeks
- Hard to do daily tasks or care for yourself
- Using substances to cope
- Thoughts of self-harm or suicide (seek urgent help)
Talking to a clinician
- “For the past month I’ve had low mood, low energy, poor sleep, and no interest in things. It’s affecting work. I’d like to discuss therapy options and whether medication could help.”
Outlook
Recovery is common. Progress is often gradual—more good moments, better sleep, a bit more energy. If something isn’t helping, it’s okay to adjust the plan.
Resources for readers in the USA
- Immediate help: 988 Suicide & Crisis Lifeline (call/text 988); Crisis Text Line (text HOME to 741741); Veterans: 988 then 1; The Trevor Project (LGBTQ+ youth): 1-866-488-7386 or text START to 678678
- Find care: FindTreatment.gov; Psychology Today directory; NAMI HelpLine (nami.org/help)
- Low-cost/community: Open Path Collective; Community Health Centers (findahealthcenter.hrsa.gov); 211
- Insurance tips: Confirm in-network mental health benefits, deductible, copay/coinsurance, telehealth coverage, prior authorization, out-of-network reimbursement, out-of-pocket max; note rep name/date/reference number
- Work/school supports: FMLA, ADA accommodations, EAP; campus counseling
- Urgent options besides ER: Mobile Crisis via 988 (where available), behavioral urgent care
Disclaimer: Educational information, not a diagnosis. If in crisis, use the resources above.